| NPI | 1235357088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 49420) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 50113) |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: MN 50113) | |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2019-05-15 |